Joined: Fri Apr 01, 2011 11:51 amPosts: 6561Location: United States of New England

i would not be surprised if you cant refuse the HIV test. based on the few births i watched in hypnobirth class it seems like 1000 gallons of blood and bodily fluids gush out of you *shudders*seems like the HIV test would definitely be necessary to protect everyone involved. and obviously it would be good to know because it can (will?) be passed onto the baby.

No, you can't refuse the HIV test because it's considered the best way to stop infections from mother to child - that is the one and only reason for the law. You can refuse it, but if you refuse it, your child will be tested at birth without your consent. The other part of the law though is that THEY DO NOT HAVE TO INFORM YOU THEY'RE TESTING YOU. The test is put in with normal first and third trimester screenings and they are not required by law to do ANY pre-counseling before administering it or to receive ANY consent. It is an opt-out test rather than an opt-in, and they don't have to give you the opportunity to opt out (by telling you they're doing it). It is absolute and utter bullshiitake and unequal treatment of pregnant women. There's no other group of patients who lack the right to know informed consent around HIV testing and it is utterly demented that you might be presented with an HIV diagnosis without even knowing you've been tested.

There's no reason the hospital would refuse to treat you and they are barred from doing so by law on multiple grounds (EMTALA for a start). Hospitals do not generally know the HIV status of new patients and do not routinely test patients for HIV for no cause.

No, you can't refuse the HIV test because it's considered the best way to stop infections from mother to child - that is the one and only reason for the law. You can refuse it, but if you refuse it, your child will be tested at birth without your consent. The other part of the law though is that THEY DO NOT HAVE TO INFORM YOU THEY'RE TESTING YOU. The test is put in with normal first and third trimester screenings and they are not required by law to do ANY pre-counseling before administering it or to receive ANY consent. It is an opt-out test rather than an opt-in, and they don't have to give you the opportunity to opt out (by telling you they're doing it). It is absolute and utter bullshiitake and unequal treatment of pregnant women. There's no other group of patients who lack the right to know informed consent around HIV testing and it is utterly demented that you might be presented with an HIV diagnosis without even knowing you've been tested.

There's no reason the hospital would refuse to treat you and they are barred from doing so by law on multiple grounds (EMTALA for a start). Hospitals do not generally know the HIV status of new patients and do not routinely test patients for HIV for no cause.

Thanks for the correction. I appreciate the info, that makes a lot of sense.

_________________My oven is bigger on the inside, and it produces lots of wibbly wobbly, cake wakey... stuff. - The PoopieB.

Yeah, mandatory HIV testing is definitely not to protect providers. If you were to refuse testing during pregnancy, your baby would be taken away from you by the hospital at birth, held in the NICU, and you would not be allowed to breastfeed until its HIV results came back.

Gonorrhea is really the only infection that's sensitive to the erythromycin eye ointment, and it's not really effective if it's given to the baby more than an hour after birth. So, it's kind of pointless to delay it for several hours in order to allow for bonding time (and I agree that it definitely may disrupt that time). If you do not have gonorrhea, you might as well decline it.

"Three agents are licensed for neonatal ocular prophylaxis in the United States: 1% silver nitrate solution, 0.5% erythromycin ointment, and 1% tetracycline ophthalmic ointment or suspension. However, only 0.5% erythromycin ointment is available commercially in the United States. Although all 3 agents are effective against gonococcus [gonorrhea], none prevents transmission of C trachomatis [chlamydia] from mother to infant."

Joined: Fri Apr 01, 2011 11:51 amPosts: 6561Location: United States of New England

Ariann wrote:

The other part of the law though is that THEY DO NOT HAVE TO INFORM YOU THEY'RE TESTING YOU.

you know i was trying to remember if they told me i was being tested for HIV when they took my 10 vials of blood at the beginning. i cant remember but i dont think they did. i think i only found out after when someone here told me what that 10 vials of blood was for cause i was like "OMG THEY TOOK SO MUCH BLOOD!"

i may or may not have just had my 2nd HIV test as part of the 3rd trimester. they took either 4 or 6 (cant remember) vials last time.

one was for glucose and one was something to do with my blood type being Rh- and one was for anemia.well actually i dont know how many vials go with each but those are the 3 things i was aware of.

i dont particularly care that they tested me for HIV but i do agree it's kind of B.S. not to have that info up front.i dont know why someone would refuse it but i do believe very strongly in patient consent.

my husband just had a life insurance physical recently and they tested him for HIV. ill have to ask him if he knew up front.

Joined: Fri Apr 01, 2011 11:51 amPosts: 6561Location: United States of New England

mooo wrote:

you would not be allowed to breastfeed until its HIV results came back.

Gonorrhea is really the only infection that's sensitive to the erythromycin eye ointment, and it's not really effective if it's given to the baby more than an hour after birth. So, it's kind of pointless to delay it for several hours in order to allow for bonding time (and I agree that it definitely may disrupt that time). If you do not have gonorrhea, you might as well decline it.

hmmm i didnt know that. maybe i will just decline it. thanks for the info.ill talk to the husband tonight.

You might want to decline HIV testing because a) you've been recently tested and have no recent route of exposure, b) you don't think you should have to pay for unnecessary testing, and c) because it might put you at risk for partner violence if your partner finds out you are positive (even if your partner gave it to you), or at risk of losing family support. But in any case, I don't think pregnant women should have fewer healthcare rights than any other adult.

HIV is still a special class of disease in most of the world too... you wouldn't be fired from your job or stigmatized by society for any other infectious disease... that's why HIV testing is supposed to be so private. when i've gotten HIV tested while not pregnant, it's been an option to do it anonymously.

Joined: Fri Apr 01, 2011 11:51 amPosts: 6561Location: United States of New England

i was thinking about this on the way home and i was wondering if it also was a health insurance consideration.like having an HIV + diagnosis on your "record" following you around for health insurance purposes.

the only reason i say that is because i used to have severe sleep apnea and had major surgery to correct it. afterwards typically you have a post op sleep study done to show how much the sleep apnea is gone. my sleep dr (not the surgeon) told me it was totally up to me whether i actually wanted to do it because there was a chance i still had very mild apnea and i might not want that diagnosis following me around on my health insurance because it could create problems for me down the road. i didnt end up doing on cause....well....let's just say there is nothing more fun than having electrodes glued to your head and body and then being told to sleep on your back (very uncomfortable for me!) while they point cameras at you all night!

Yes, same with my sleep apnea. I might still have it since they thought it was my jaw shape and not morbid obesity, but the diagnosis is not a good one to have. Although in my case, it greenlit my weight loss surgery immediately.

_________________"This is the creepiest post ever if you don't know who Molly is." -Fee"a vegan death match sounds like something where we all end up hugging." -LisaPunk

If it's hard for you to look up, you should just ask your OB, she'll know. Alternatively, call the hospital where you're going to deliver. For some reason this kind of stuff is really hard to find out online. I had my husband do all the sleuthing around this for me because lawyers are good at looking up laws. It's even more complicated because it's not really law in a lot of places, it's administrative directions related to the professionals you're working with, which can be really hard to find. Sometimes the office of public health (or whatever it's called in MA) will be helpful with that stuff.

Good luck with the immunizations, oncewerewesties! The first shots Lydia got really were no big deal because nursing was so good at calming her instantly.

oh man, she did calm down very quickly [though she didn't want to feed] but I am traumatised - the noise she made when the injections went in was like nothing I have ever heard, and the first scream she let out was so big she held her breath for probably 20 seconds and went from pink to red to almost purple before she started crying again. And she squeezed out her first tear!She pretty much just wanted to sleep the rest of the day though, and didn't eat as much as usual.I need to start preparing myself now for the next round in six weeks...On the up side, a day of snuggling a sleepy baby was lovely [if a little tiring on the arms].And of course, the real up side - no nasty diseases!